Hepatopulmonary syndrome

Fallon, Michael B.; Abrams, Gary A.

doi:10.1097/mog.0000000000000067

Cited by 19 publications

(8 citation statements)

References 47 publications

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“…Despite the retrospective, cross-sectional, and observational nature of the present study, our findings suggest that liver vessel involvement should be added to the list of the mechanisms leading to HPS 8,22 . Although our results cannot firmly establish that the intra-and extrahepatic changes associated with HPS precede the development this syndrome, the vascular pattern of damage we observed in patients with HPS raises the hypothesis that obstruction of intrahepatic portal branches and hepatic venules are a primary event in the development of pulmonary changes.…”

Section: Discussionmentioning

confidence: 55%

“…Data on the mechanisms leading to the key features of HPS, namely pulmonary microvascular dilatations and angiogenesis, have been obtained in rats with chronic common bile duct ligation 7 . In this model, pulmonary vasodilatation results from the interaction between an increased release of endothelin-1 by the liver and an enhanced lung endothelin B receptor expression due to the hyperdynamic circulation of cirrhosis 8 .…”

mentioning

confidence: 99%

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Evidence for an Association Between Intrahepatic Vascular Changes and the Development of Hepatopulmonary Syndrome

Lejealle

Paradis

Bruno

et al. 2019

Chest

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Section: Discussionmentioning

confidence: 55%

mentioning

confidence: 99%

Evidence for an Association Between Intrahepatic Vascular Changes and the Development of Hepatopulmonary Syndrome

Lejealle

Paradis

Bruno

et al. 2019

Chest

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“…Several studies have reported the effects of quercetin on the liver in this model. In addition, we believe that the correlation of severity between the HPS and liver disease is not reliable ( 45 ). In addition to this model, neither HPS nor pulmonary vascular angiogenesis was observed in various other models with severe liver cirrhosis ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

Quercetin alleviates pulmonary angiogenesis in a rat model of hepatopulmonary syndrome

Chen

Wang

et al. 2016

Braz J Med Biol Res

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Quercetin shows protective effects against hepatopulmonary syndrome (HPS), as demonstrated in a rat model. However, whether these effects involve pulmonary vascular angiogenesis in HPS remains unclear. Therefore, this study aimed to assess the effect of quercetin on pulmonary vascular angiogenesis and explore the underlying mechanisms. Male Sprague-Dawley rats weighing 200-250 g underwent sham operation or common bile duct ligation (CBDL). Two weeks after surgery, HIF-1α and NFκB levels were assessed in rat lung tissue by immunohistochemistry and western blot. Then, CBDL and sham-operated rats were further divided into 2 subgroups each to receive intraperitoneal administration of quercetin (50 mg/kg daily) or 0.2% Tween for two weeks: Sham (Sham+Tween; n=8), CBDL (CBDL+Tween; n=8), Q (Sham+quercetin; n=8), and CBDL+Q (CBDL+quercetin; n=8). After treatment, lung tissue specimens were assessed for protein (immunohistochemistry and western blot) and/or gene expression (quantitative real-time PCR) levels of relevant disease markers, including VEGFA, VEGFR2, Akt/p-Akt, HIF-1α, vWf, and IκB/p-IκB. Finally, arterial blood was analyzed for alveolar arterial oxygen pressure gradient (AaPO2). Two weeks after CBDL, HIF-1α expression in the lung decreased, but was gradually restored at four weeks. Treatment with quercetin did not significantly alter HIF-1α levels, but did reduce AaPO2 as well as lung tissue NF-κB activity, VEGFA gene and protein levels, Akt activity, and angiogenesis. Although hypoxia is an important feature in HPS, our findings suggest that HIF-1α was not the main cause for the VEGFA increase. Interestingly, quercetin inhibited pulmonary vascular angiogenesis in rats with HPS, with involvement of Akt/NF-κB and VEGFA/VEGFR-2 pathways.

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“…Hepatopulmonary syndrome (HPS) is characterized by hypoxia in patients with chronic liver diseases, especially in those with cirrhosis [7]. Emerging data show that the prevalence of HPS ranges from 5 to 32% in cirrhotic patients who need liver transplantation [8].…”

Section: Introductionmentioning

confidence: 99%

Effects of Caffeine Treatment on Hepatopulmonary Syndrome in Biliary Cirrhotic Rats

Chang

Chuang

Tsai

et al. 2019

IJMS

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Hepatopulmonary syndrome (HPS) is a lethal complication of cirrhosis characterized by hypoxia and overt intrapulmonary shunting. In this study, we investigated the effect of caffeine in rats with common bile duct ligation (CBDL)-induced liver cirrhosis and HPS. CBDL rats were randomly allocated to receive caffeine or vehicle for 14 days. On the 28th day after CBDL, mortality rate, hemodynamics, liver, and renal biochemistry parameters and arterial blood gas analysis were evaluated. Lung and liver were dissected for the evaluation of inflammation, angiogenesis and protein expressions. In another series with parallel groups, the intrapulmonary shunting was determined. Caffeine significantly reduced portal pressure (caffeine vs. control: 10.0 ± 3.7 vs. 17.0 ± 8.1 mmHg, p < 0.05) in CBDL rats. The mortality rate, mean arterial pressure, biochemistry data and hypoxia were similar between caffeine-treated and control groups. Caffeine alleviated liver fibrosis and intrahepatic angiogenesis but intrapulmonary inflammation and angiogenesis were not ameliorated. The hepatic VEGF/Rho-A protein expressions were down-regulated but the pulmonary inflammation- and angiogenesis-related protein expressions were not significantly altered by caffeine. Caffeine did not reduce the intrapulmonary shunting, either. Caffeine has been shown to significantly improve liver fibrosis, intrahepatic angiogenesis and portal hypertension in cirrhotic rats, however, it does not ameliorate HPS.

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Hepatopulmonary syndrome

Abstract: Mechanisms of disease continue to be defined in HPS, providing potential targets for pharmacologic intervention. Outcomes after liver transplantation are also becoming clearer, including the management of HPS with severe hypoxemia.

Cited by 19 publications

References 47 publications

Evidence for an Association Between Intrahepatic Vascular Changes and the Development of Hepatopulmonary Syndrome

Evidence for an Association Between Intrahepatic Vascular Changes and the Development of Hepatopulmonary Syndrome

Quercetin alleviates pulmonary angiogenesis in a rat model of hepatopulmonary syndrome

Effects of Caffeine Treatment on Hepatopulmonary Syndrome in Biliary Cirrhotic Rats

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